- Novo Nordisk Inc. (Plainsboro, NJ)
- About the Department The Clinical, Medical and Regulatory (CMR) department at Novo Nordisk is one of the most diverse and collaborative groups within the ... and developing and implementing regulatory strategies with the FDA to providing medical education and collecting data to support efficacy and new product… more
- Northwell Health (Westbury, NY)
- …diagnostic information leading to the assignment can be substantiated by the documentation in the Medical Record. Seeking RN - BSN or MSN candidates with a HCS-D ... charts to ensure that proper standards are maintained in compliance with Federal and State regulations. 5.Applies coding rules...and related experience. 2.Current License to practice as a Registered Professional Nurse in New York State… more
- US Tech Solutions (Newark, NJ)
- …of related experience, preferably in the healthcare industry. + **Active New Jersey Registered Nurse ( RN ) License required.** **Skills:** + Knowledge of ... months contract with potential extends or Convert** **Job Description:** + The HEDIS Nurse Auditor is responsible for conducting quality audits related to state… more
- UPMC (Pittsburgh, PA)
- …Registered Health Information Technician (RHIT) + OR Licensed Professional Nurse (LPN) + Registered Nurse ( RN ) Required: + Act 34 **UPMC is an Equal ... **Join UPMC Corporate Compliance as an Intermediate Compliance Auditor !** Are you passionate about ensuring... (CPMA) + Certified Professional Coder (CPC) + Certified Medical Coder (CMC) + OR Registered Health… more
- Molina Healthcare (Bronx, NY)
- …and/or managed care, or equivalent combination of relevant education and experience. * Registered Nurse ( RN ). License must be active and unrestricted ... functional areas in alignment with regulatory requirements - ensuring quality compliance and desired member outcomes. Contributes to overarching strategy to provide… more
- UPMC (Pittsburgh, PA)
- …Registered Health Information Technician (RHIT) + Licensed Professional Nurse (LPN) or + Registered Nurse ( RN ) + Act 34 **UPMC is an Equal Opportunity ... **Join UPMC Corporate Finance as a Compliance Auditor , Associate!** Are you detail-oriented... (CPMA) + Certified Professional Coder (CPC) + Certified Medical Coder (CMC) + Registered Health Information… more
- Humana (Corpus Christi, TX)
- …process management as needed. Requires applicable State licensure in field of study: Registered Nurse ( RN ), Licensed Masters Clinical Social Worker (LCSW), ... 1 consults and collaborates with clinicians to ensure high accountability of compliance and quality. The Quality Assurance, Clinical Professional 1 work assignments… more
- Guthrie (Sayre, PA)
- Option to be Hybrid/Remote. Summary: A senior level compliance coding auditor conducting assessments in accordance with The Guthrie Clinic's policies and ... procedures and accepted guidelines for medical coding. Works closely with the Compliance ...(RHIA, RHIT, or CCS) or AAPC (CPC) required + RN /LPN or CPMA preferred + Required to sit for… more
- Marshfield Clinic (Marshfield, WI)
- …together to support the most exciting missions in the world!** **Job Title:** Nurse Auditor - Revenue Integrity (Remote in Wisconsin) **Cost Center:** 101651059 ... **_**Wisconsin residents only eligible to apply**_** **JOB SUMMARY** The Nurse Auditor - Revenue Integrity is responsible...are substantially related to the position._ **Minimum Required:** + Registered Nurse license awarded by the State… more
- Childrens Hospital of The King's Daughters (Chesapeake, VA)
- + GENERAL SUMMARY + The Revenue Integrity Nurse Auditor is responsible for the auditing and compliance functions necessary to effect accurate and complete ... medical necessity or appropriateness of services. + Conducts compliance , defense, LifeNet and special focus audits and reports...AND/OR CERTIFICATIONS + Current Virginia state license as a Registered Nurse or Registered … more
- Mount Sinai Health System (New York, NY)
- …Technologist and related professions). + Certifications such as Certified Professional Medical Auditor (CPMA), Certified Inpatient Coder (CIC), Certified Coding ... **Job Description** **Clinical Revenue Auditor -CDM Patient Financial Services-Corporate-Full-Time-Days- Hybrid.** The Clinical Revenue...a key role in ensuring the financial health and compliance of the organization and bridges the gap between… more
- UNC Health Care (Chapel Hill, NC)
- …Association) certification - AAPC (American Academy of Professional Coders) certification - RN ( Registered Nurse ) license - LPN (Licensed Practical ... the state to train and shadow round with Clinical Documentation Specialists. The CDS auditor provides elbow to elbow support during training and education as well as… more
- Community Health Systems (Franklin, TN)
- **Job Summary** The DRG Denials Auditor conducts hospital inpatient DRG denial audits for both RAC and non-RAC accounts, reviewing patient records for accuracy in ... discharge disposition, and any other relevant data to ensure coding accuracy. The auditor is also responsible for writing and defending appeal letters to payers with… more
- Insight Global (Plano, TX)
- …or a third-party vendor as a DRG Auditor or Clinical Documentation Specialist (CDS). Prior experience of working as a CDI/Coding auditor RN background ... DRG Auditors to join a remote healthcare organization. The DRG Revenue Integrity Auditor will perform Diagnostic Related Group (DRG) validation and quality audits on… more
- University of Washington (Seattle, WA)
- …**Desired Qualifications** . Master's Degree in business, accounting or related discipline . Medical coding knowledge or experience . RN or equivalent provider ... intellectual excitement, artistic pursuits, and natural beauty. The senior healthcare auditor is responsible for the completion of internal audits within the… more
- St. Luke's University Health Network (Allentown, PA)
- …Works inside with adequate lighting, comfortable temperature and ventilation. EDUCATION: Registered Nurse required, BSN preferred. Current license required. . ... care. The RN Clinical Review Appeals Specialist retrospectively reviews patient medical records, claims data and coding of all diagnosis and procedure codes to… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …investigating and remediating allegations of FWA while adhering to compliance and regulatory requirements. Primary activities include substantiating referrals, case ... planning and research, conducting onsite or desk audits, clinical reviews of medical records to ensure correct billing of services and appropriateness of care,… more
- Molina Healthcare (IA)
- …related field or equivalent experience, OR completion of any of the following programs: + Registered Nurse ( RN ) or State Licensed Vocational Nurse (LVN), ... OR completion of any of the following programs: + Registered Nurse ( RN ) or State...may be preferred for specific roles) * Certified HEDIS Compliance Auditor (CHCA) **PHY** **S** **I** **C**… more
- Commonwealth Care Alliance (Boston, MA)
- …Professional Coder (CPC) + Certified Inpatient Coder (CIC) + Certified Professional Medical Auditor (CPMA) **Desired Education (nice to have):** + Masters ... direction of the Sr. Director, TPA Management and Claims Compliance , Healthcare Medical Claims Coding Sr. Analyst...applicable)), an OIG Report and verification of a valid MA/ RN license (if applicable). Commonwealth Care Alliance is an… more
Related Job Searches:
Auditor,
Compliance,
Compliance Auditor,
Medical,
Medical Auditor Compliance,
Medical Compliance,
RN,
RN Auditor